Gazette opinion: Rural Montana needs Medicaid expansion

Apr 10, 2019

The Montana Senate will soon take one of the most important votes of the biennial session. Our 50 senators will decide whether 96,000 Montanans can keep their health coverage past June 30.

Once again, we call on our elected leaders to do the right thing: Renew Medicaid expansion, the successful program that Montana started in January 2016 that has reduced the state's uninsured ranks by more than half. Allow very low-income Montanans to continue to have access to quality, affordable health care. Assure low-wage, seasonal and small business workers that they will have continuing health coverage. Continue the state's major source of payment for treatment of substance abuse disorders and mental illnesses — a lifeline for thousands of Montanans who need help to get their lives and jobs back.

Every one of Montana's 56 counties has Medicaid expansion enrollees. Every county has businesses that employ Medicaid enrollees. But without approval by a majority of senators, the benefits of Medicaid expansion will end in less than three months.

In Custer County, 62 percent of all businesses employ a Medicaid expansion enrollee who received job services through HELP-Link, which is a key part of Montana Medicaid expansion. In fact, every county is home to businesses employing Medicaid enrollees whose job search was bolstered by the the health care program. Fifty businesses in Fallon County, 151 in Richland County, 70 in Stillwater County and 55 in Sweet Grass County employ Medicaid expansion enrollees.

In our region, more than half of all employers in these counties have one or more workers covered by Medicaid expansion: Big Horn, Broadwater, Carbon, Fergus, Garfield, Golden Valley, Mussellshell, Park, Phillips, Prairie, Roosevelt, Rosebud, Valley, Wheatland and Yellowstone. These statistics were compiled by the Montana Department of Labor and Industry and analyzed by the Montana Budget & Policy Center.

Montana hospitals have agreed to help cover the state's 10 percent share of Medicaid expansion services. There will be very little net increase in Montana taxpayers' costs of caring for 96,000 enrollees — if the Senate approves HB658 as it is now written. That's because the federal government will pay 90 percent of Medicaid expansion care costs, compared with 65 percent of traditional Medicaid costs. (Without Medicaid expansion, some current enrollees would qualify for traditional Medicaid.) Also, Medicaid expansion covers some costs of inmate medical care that otherwise would have to be paid by the state or counties.

If you want your neighbors, your employees, your coworkers and your family to have access to the quality health care they need when they need it, please tell your state senator today. Leave a phone message at 406-444-4800 or go online to leg.mt.gov and clinic on "message a legislator". The situation is urgent, don't let Montana health care expire. Approve HB658.